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Throat clearing, coughing mucus, hoarse voice, green-yellow nasal mucus, headache, ear discomfort. What is causing this?

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ENT Specialist
Practicing since : 2001
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Male 64 years 5ft 11ins 172 lbs. Asthma as a child-resolved at puberty.perennial rhinitis all adult life.
5 months cough following viral infection, diagnosed as asthma via spirometry and nitric oxide at 70 ppb.Prescribed oral steroid burst of two weeks, followed by symbicort 400/12 five weeks ago+montelukast 10mg, which continue. Now constant throat clearing,sometimes coughing up clear mucus, hoarse voice and hugely increased green/yellow nasal mucus, some slight headaches and ear discomfort. No fever. Pleural HRCT clear one month ago. Nasal endoscopy nine months ago - clear. Being treated by asthma doctor but wonder if I should see ENT. At my wits end as to what is causing this.
Posted Thu, 26 Apr 2012 in Ear, Nose and Throat Problems
Answered by Dr. Naveen Kumar 14 hours later

Thanks for the query

Constant throat clearing, cough with expectoration, hoarseness, headache and ear discomfort are all the features of sinusitis.

As you have mentioned that you have perennial rhinitis, this could be the main reason for causing allergic rhino sinusitis. Allergic rhinitis will increase the congestion in the nose, because of which there will be blockage of the sinus opening leading to stagnation of the secretions in the sinus and increased viscosity. Stagnation of the secretions gives rise to headache and nasal infection. Congestion of the nose will also cause blockage of the Eustachian tube (the tube connecting nose and the ear) leading to ear discomfort and reduced hearing.

Nasal endoscopy is one of the investing aids for sinusitis and not the investigation of choice for allergic rhino sinusitis. A computerized tomography (CT) scan of the paranasal sinuses gives an accurate picture of the sinuses and helps to confirm the diagnosis.

I would suggest you to do steam inhalation 2-3 times a day, which helps in reducing the nasal congestion and clearing of the mucus. Drink plenty of warm water to keep the nose and the throat hydrated. Avoid coffee and chilled beverages. Also, you will require a course of good antibiotic, a mucolytic to reduce the viscosity of the mucus and a steroid nasal spray for control of allergy. Please do consult your ENT specialist for a thorough evaluation and management.

Hope I have answered your query; I will be available for the follow-up queries.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
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